AB0199 RELATIONSHIP BETWEEN EXERCISE AND DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS
Authors: A. N. Garza-Cisneros, I. J. Colunga-Pedraza, D. Á. Galarza-Delgado, J. R. Azpiri-López, A. B. Rodriguez-Romero, M. A. Balderas-Palacios, A. Garcia-Heredia, N. Guajardo-Jauregui, A. Cárdenas
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is a chronic, autoimmune, inflammatory disease in which cardiovascular disease is the leading cause of death (1). Exercise has been shown to have certain benefits in chronic diseases such as RA, decreasing symptoms and disease activity (2). Objectives To correlate exercise and minutes of physical activity performed per week with the disease activity level in a Mexican RA population. Methods This was a cross-sectional study in which a total of 240 Mexican patients with a diagnosis of RA were included. They were divided into two groups (120 in each): those who self-reported performing at least 30 minutes of exercise 3 or more times per week and were matched with patients who did not perform it by age, gender, and comorbidities. The disease activity level was determined with Disease Activity Score 28-joint erythrocyte sedimentation rate (DAS28-ESR) and Disease Activity Score 28-joint C-reactive protein (DAS28-CRP). Distribution was evaluated with Kolmogorov-Smirnov. Comparisons with Chi-square test, Student’s t-test, and Mann-Whitney U test. Correlation between disease activity level and minutes of exercise per day with Spearman-rho coefficient. Results DAS28-ESR was significantly higher in patients who did not exercise [4.024 (3.08-5.31) vs 4.73 (3.6-54.82), p=0 .006]. DAS28-CRP had similar trend [2.76 (1.89-4.14) vs 3.51 (2.28-4.63), p=0. 004] (Table 1). Table 1. Demographic characteristics of the patients. Characteristics RA patients whoexercise (n=120) RA patients whodo not exercise (n=120) Value of p Age, mean ± SD 54.4±8.1 54.5±8.2 NS Female gender, n (%) 106 (88.3) 106 (88.3) NS Obesity, n (%) 23 (19. 1) 31 (25.8) NS T2DM, n (%) 15 (12.5) 12 (10.0) NS Hypertension, n (%) 30 (25.0) 24 (20.0) NS Dyslipidemia, n (%) 39 (32.5) 34 (28.3) NS Methotrexate, n (%) 93 (77.5) 107 (89.1) 0.015 bDMARD, n (%) 6 (5) 5 (4.1) NS Glucocorticoid, n (%) 61 (50.8) 74 (61.6) NS Minutes of exercise perweek, median (p25- p75) 180 (150-300) 0 - DAS28ESR, median (p25-p75) 4.024 (3.08-5.31) 4.73 (3.6-54.82) 0.006 DAS28CRP, median (p25-p75) 2.76 (1.89-4.14) 3.51 (2.28-4.63) 0.004 RA, rheumatoid arthritis; NS, not significant; T2DM, type 2 diabetes mellitus; bDMARD, biological disease-modifying anti-rheumatic drugs; DAS28, Disease Activity Score 28-joints; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein. The Spearman-rho coefficient showed a significant correlation between the minutes of exercise performed per week and DAS28-ESR (rho=-0.193, p=0. 003) and DAS28-CRP (rho=-0.207, p=0. 001) (Figure 1). A multivariate analysis was performed in which minutes of exercise performed per week, treatment, and comorbidities were included, showing an independent association between minutes of exercise performed per week and the disease activity level assessed by DAS28-ESR (B=-0.001, 95% CI= -0.002- -0.0003, p=0 .011) and DAS28-CRP (B=-0.001, 95% CI= -0.002- -0.0003, p=0. 011). Figure 1. Correlation between exercise time and disease activity level in RA. RA, rheumatoid arthritis; DAS28, Disease Activity Score 28-joints; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein. Conclusion Mexican RA patients who exercise presented lower levels of disease activity. Emphasis should be placed on their practice to improve the patients’ symptomatology. References [1]Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, et al. Rheumatoid arthritis. Nat Rev Dis Prim [Internet]. 2018;4:1–23. Available from: http://dx.doi.org/10.1038/nrdp.2018.1 [2]Katz P, Andonian BJ, Huffman KM. Benefits and promotion of physical activity in rheumatoid arthritis. Curr Opin Rheumatol. 2020;32(3):307–14. Disclosure of Interests None declared